Lower Back Pain – What can You Do

The following information is a guide only.  It contains detailed technical information regarding products and procedures, some of which you may not have heard of. It is intended as guide to demonstrate the range of treatment options available that you should consider. If you require further explanation please ask your Physiotherapist, they will be happy to assist you.

What Does Your Injury Involve?

        • Trauma

        • Ongoing Pathology – such as MS, Fracture healing, Scar Tissue

        • Pain +/- hypersensitivity

        • Inflammation

        • Muscle Weakness

        • Muscle Spasm

        • Muscle Tightness

        • Nerve Tightness

        • Capsular Tightness

        • Biomechanical Faults

What Can You Do?

              • Address all of the above points

              • Seek Expert Medical Opinion from your Physiotherapist, General Practitioner, Specialist Doctor

              • Understand your Condition

Read about it and ask your Healthcare Practitioners until all of your questions are answered.  Such as why did it happen? What structures are involved? How long should it last? What can I do to help it get better? How do I stop it coming back?

                                  • Get an Accurate Diagnosis

                                  • Get the appropriate Investigations Done (MRI, CT, X-ray, Ultrasound, Blood Test)

What Should I try?

                                  • Exercises – Specifc Stabilising exercises first to ensure correct alignment, muscle activation and control. Then progress to strengthening / muscle building exercises, then sports/ functional specific exercises

NOTE:  Rehabilitation needs to be as specific and well controlled/ supervised as possible to achieve maximal effectiveness.   Physiotherapist are highly trained in exercise based rehabilitation.   A poorly constructed program or one with no specific goals can be not only ineffective but dangerous.

                                  • Mobilisation of the Joints, Muscles, Ligaments and Nerves

                                  • Manipulation

Manipulation is traumatic and potentially VERY dangerous. It must only be used when absolutely necessary and only by highly qualified Practitioners that carry out Pre Manipulation Testing which tests your likelihood of suffering a stroke or other serious outcomes prior to manipulation.

                                    • Massage

Deep, Relaxation, Myofascial Release, Acupressure, Transverse Frictions etc – there are many techniques that are appropriate for different conditions.  Note that Physiotherpist do massage only treatments if requested.

                                    • Nerve Stretching

                                    • Dry Needling

                                    • Taping

                                    • Specific Equipment

Ultrasound, Interferrential/ TENS, Laser, Vibration, Traction

                                    • Specific Technique

                                      (Bowen, Alexander, Pilates, Mulligan, McConnell, Feldenkrias, others)

                                    • Pain Management Techniques

( Pacing techniques, Hurt vs harm, Flare up plans, Education regarding de conditioning and disuse, Distraction techniques, Goal setting, Coping with negative thoughts, Progressive Muscle Relaxation, Self hypnosis, Meditation, Pain & Pain Behaviour (link to further pain education David Butler – link )

What Should I Buy?

                                  • Cold & Hot packs (safe drug free alternative to pain and inflammation management)

                                  • Braces (back brace, ankle brace, knee brace, posture brace – all effective if fitted and used appropriately)

                                  • Appliances – TENS Machine (pain control), Seat Support (Therapod), Orthotics, Inner Soles, Pillows, Creams & Gels, Walking Aids such as crutches, walking stick, wheel chair, New mattress, New shoes, Splints, Rehab equipment.

There is A LOT of equipment available.   The equipment you choose to buy is FAR more effective if you have it prescribed by a Physiotherapist.   This will ensure it is the correct size, correct design and appropriate for what your needs are.   For example a knee brace is not simply a knee brace.  Do you want it to limit extension or lateral flexion? Do you need pre patella support? Do you need an open knee cap? Do you anchor points or a simnple slide on/off model?  Do you nedd it light weight? Do you need it breathable?  When should you wear it? How do you know if it is working effectively?.  Your physio can test it while it is on to ensure it is limiting what it needs to, Are there any medical reasons you should not be wearing it such as poor circulation, skin conditions or allergies?

There are literally millions of dollars wasted each year on inappropriate “fix it now” items.   Put your money toward something useful and stop wastage.  Ask your Physiotherapist and do not buy something you will throw away.

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